Dr. Sargon Lazarof's Ultratooth Is About to Revolutionize Global Dentistry

By Scott S. Smith | Friday, 10 June 2022 | Feature, Business, Interviews

Sargon Lazarof, DDS, thought the superiority of his dental implant for patients with missing teeth meant it would be eagerly embraced by dentists, but it has taken three decades to overcome resistance.

Against All Odds, Dr. Lazarof's Permanent Dental Implant Is Becoming Popular Worldwide

In 1988, a few years out of dental school, Sargon Lazarof, DDS, attended a seminar about dental implants. These are considered the best solution to teeth that have been lost, whether in an accident or due to inadequate brushing and flossing. That is because they are surgically anchored into the jawbone via the missing tooth's socket, which keeps other teeth from becoming misaligned, a natural process by the body to "fill the gap." Neither dentures nor bridges can do that.

Prior to placement of the implant, bone and gum grafts may be required where they have been lost due to extraction or accidents (also a normal process). 

The traditional procedure has been to insert the screw-like implant, made of a biocompatible material like zirconium or titanium, and let it gradually integrate with the jawbone for 4-6 months. Then it is attached to a dental crown, which looks like the visible part of a tooth. 

"As I listened, I wondered why the implant couldn't be designed so that it was stable and integrated from the start so that the crown could be put on immediately," Dr. Lazarof told Startup Savant. "I raised my hand to ask the question, but before the lecturer could call on me, I lowered it since he was known as someone who copied others' ideas, and I wanted to think about this before I made it public."

A few nights later, he awoke at 4 a.m. and told his wife he had some ideas for a new type of implant he wanted to sketch out. They later spoke with her father, a mechanical engineer, who made some suggestions to improve the prospects for what Lazarof would designate as an immediate-load implant, eventually called the Ultratooth.

He took a prototype to the factory that provided most of the world's implant brands, whose CEO was so excited he made a deal: he would make as many prototypes as were needed to test their viability at no cost, if Lazarof agreed to make his company the exclusive supplier if they proved successful. It was a relationship that would last 27 years until the company was sold.

Working with early adopters who heard about his invention, Lazarof gradually improved the design, though his mentors continued to insist that immediate integration was impossible. In 1991, he had enough experience to write about it in “Dentistry Today,” and the next year applied to the Food and Drug Administration for a patent. In 1994, what is now known as the Ultratooth, the first immediate-load and permanent dental implant, was approved.

The prospects for worldwide demand looked enormous even then. According to the American Academy of Implant Dentistry, about 15 million Americans a year have teeth replaced with bridges or crowns. With 66% of those aged 40-64 having already lost at least one tooth and 19% of those over 65 missing all their teeth, the domestic prospects for a better implant should be excellent. And according to the FDI World Dental Foundation, 30% of the global population has no teeth. Grandview Research estimated the total world market for implants in 2021 as $4.4 billion and projected that it would nearly double by 2028, with the pandemic subsiding and economies recovering, while cosmetic dentistry became more popular everywhere.

Few people understand the importance of good oral health to overall wellbeing. Inadequate brushing and flossing lead not just to cavities (still the second most common disease, behind only the more common cold) but to the proliferation of periodontal bacteria throughout the body. This significantly raises the risk for diabetes, cardiovascular disease, rheumatoid arthritis, some types of cancer, and even dementia, according to WebMD. 

Lazarof knew his implant would get fierce resistance from all the other implant lines, one of which was a major backer of his alma mater, the University of Southern California School of Dentistry. With the enthusiastic support of a respected professor who had been using the "Sargon implant," as it was becoming known, they approached the dean and proposed a five-year study of its efficacy. He agreed, and Lazarof financed the $200,000 cost with money from a recent distribution agreement in the Middle East. 

It began in February 1997, and Lazarof also began training dentists around the world at USC-accredited seminars. By the end of the first year of the study, USC's team had placed 40 implants with no failures (which are common with traditional implants). USC decided to abandon its exclusive relationship with a leading implant maker and also use the Sargon implant in training students. 

USC organized a conference about this revolutionary invention to be held in April 1998 in Monte Carlo, with presentations by a number of eminent dentists and a special book prepared for what turned out to be nearly 500 attendees. 

"When I received a standing ovation after my presentation, it was the best moment of my life," Lazarof said.

At the conference, the USC-allied implant maker even offered to buy him out, but he responded they could not afford to do that, despite the mere $7 million in total sales his company had up to that point. They countered that if he made them the exclusive distributor, they would guarantee $50 million in annual sales. He agreed that this might be worked out, and they would negotiate on their return.

Dental David vs. Goliath

But when he came back, he began to hear that those who had been put in charge of the study were dragging their feet under pressure from USC's primary implant maker. The trial team was supposed to have made a one-year report before the conference but kept making excuses for the delay. 

Finally, in January 1999, they issued it, but it was bare bones, saying only that the results had been very good, but with few of the details that were supposed to be included, so that it was clear that an immediate load implant had been proven to work. The major implant company had also shown little interest in following up with a distribution agreement.

"The dean kept telling me to be patient," said Lazarof. "Then I learned that the director of the study felt that his prior position as the high-profile champion of implants felted challenged by what my invention could do. He wrote an email to himself outlining a plan to discredit my implant and destroy my reputation, which he later had to turn over to my attorney. He also arranged for the other implant manufacturer to make a no-strings-attached $450,000 gift to the dental school and make all implants and equipment free of charge."

When he finally received the records of the study, Lazarof learned that the trial team had altered the patient records to make the implant results look bad. He later hired an expert in ink-dating to go through the study records and was able to prove many had been changed. 

Lazarof filed a lawsuit against USC for breach of contract in May 1999, and USC countersued in July, claiming he was in breach for misusing its trademark for the seminars sponsored by USC. 

"It was a bizarre claim because they had issued certificates to the graduates and USC received a large fee as a result," Lazarof noted. "Our suit forced USC to turn over its records, and we found all kinds of violations in the trial agreement guidelines. They had been taking patients who were too old or too young, those who had insufficient bone to support any implant, used drugs or alcohol or were smokers, or who had diabetes. They had also only done a follow-up with six of the first 23 patients. After fruitless negotiations, I terminated the agreement in December."

Lazarof had given up his Beverly Hills practice in 1996 to focus on the implant, and the trial for his suit and the USC countersuit was not set to take place until March 2003. As a smear campaign by rivals against his implant dried up sales, distributors refused to pay him for products sold, and former allies became enemies, he and Monalisa had to borrow money to open a new office in less-expensive Encino.

His insurance paid for his defense, but he had to come up with the money for the plaintiff part of the legal representations. The attorneys learned that the assigned judge was on the board of directors of the USC Institute for Corporate Counsel at the law school. He began making pre-trial rulings against Lazarof that could only be explained by bias, such as refusing to allow consideration of the alterations of the records and a claim for lost profits and damages. However, efforts to transfer the case to another judge failed.

The trial took 10 days, and his attorneys warned him that there was an inherent bias in favor of a defendant, who is always innocent until proven guilty. Despite screening jurors for bias in favor of USC, almost everyone in Los Angeles knows some of its famous alumni and the university had a generally positive image because of its championships in sports. The issues were complex, and it was expected that it would take several days for the jury to deliberate, so when they sent a note to the judge that they had reached a decision after just a couple of hours, Lazarof was worried.

But the judge announced a 12-0 verdict in favor of Lazarof in both cases. The jury awarded him $433,324, plus some legal expenses and $300,000 in interest for a total of $800,000. Some jurors were so impressed by what they learned that they became patients, he says. One later told him: "I found it terribly upsetting that in a matter of such seriousness, USC and the study director, Dr. Chee, performed their duties in such a grossly incompetent manner. It was apparent to me that Dr. Chee had no interest in fairly evaluating the implant but was rather only concerned with how he could do damage to Dr. Lazarof and the Sargon Implant System because of a great dislike for him."

But the USC team was actually smiling after the verdict because they knew what the judge planned in case they lost. Using tortured legal arguments, he shifted $51,000 of USC's trial costs to Lazarof and apportioned expenses of defendants who had been dismissed by the judge to Lazarof, then ignored the jury's decision that he was owed interest. The resulting total win was $499,156 — just $1,843 below a settlement offer that had been made by USC during negotiations. Based on the state's legal Rule 998, if Lazarof did not win more than they had offered, then he would have to pay all trial costs and attorney fees.

The judge then claimed that Lazarof's primary objective had been to recover $40 million in lost profits and damages, even though he had prevented the jury from even considering these. He ruled that since Lazarof had not achieved his goal, USC had actually prevailed, and therefore, he owed it $2 million in legal expenses. 

"Not only had I not won the $800,000 the jury of my peers said I deserved, never mind any lost profits, I was now $1.2 million in the red," Lazarof recalled. "Monalisa and I were effectively bankrupt, and our attorneys refused to appeal since they had represented me on contingency and felt there was no point in going further."

Resurrection and Revolution

Lazarof found another firm to file the appeal but was advised there was only a 15% chance of success. 

It was, therefore, a shock when on February 25, 2005, the Court of Appeals completely reversed the trial judge, coming down hard on him for tossing out the lost profits claim before the trial, yet ruling that this was Lazarof's primary purpose in suing and so had failed. The appellate judges affirmed that he had prevailed and was awarded $1.8 million, with nothing owed to USC for its legal costs. The appeals court also stated that he was allowed to pursue the fraud charge for records tampering. 

But the legal ups and downs on these issues continued, with more questionable judgments and attorney incompetence, ending with the California Supreme Court ruling in November 2012 that the Court of Appeals was correct that Lazarof was owed lost profits and damages. However, they were not convinced of the formula for the amount that was presented, and his attorney had not filed an alternative one in case the proposed formula was rejected, as he was supposed to, so the case was closed. 

But Lazarof had won the major case and began training other dentists on how to place his immediate-load implant. Instead of having to wait for a conventional implant to integrate with the jawbone, chewing very lightly for months where it is placed, Lazarof's patients are given an apple to bite on afterward to show how firmly in place the Ultratooth is. There are now several hundred dentists offering this around the US, and training is being extended into the Middle East and Europe, he says.

"The Ultratooth can be a permanent replacement with normal care," he explained. "When you hear claims that other implants are supposedly 90-95% successful, these are actually based on a five-year survival rate that excludes those that were not 'well-integrated with appropriate biomechanical loads,' according to clinical studies, which involves several qualifications that obscure how most patients do with them. It is widely believed in the industry that the failure rate is probably much higher, but no one wants to talk about it openly. The Ultratooth is currently the only device on the market that has 30 years of successful clinical history since the original Branemark implant is no longer being marketed."

Lazarof now has another office on the famed Sunset Strip in Hollywood, as well as one in Pleasant Grove, Utah, a suburb of Salt Lake City. 

"My goal is to have the Ultratooth taught in dental schools since its superiority over traditional implants is now proven," he said. "I want this to be my blessing for the whole world to save as many people as possible from suffering with missing teeth."

About the Author

Scott S. Smith

Scott S. Smith has had over 2,000 articles and interviews published in nearly 200 media, including Los Angeles Magazine, American Airlines’ American Way, and Investor’s Business Daily. His interview subjects have included Bill Gates, Richard Branson, Meg Whitman, Reed Hastings, Howard Schultz, Larry Ellison, Kathy Ireland, and Quincy Jones.